Victor Horsley's Contribution to Jacksonian Epileptology

Abstract

To describe Victor Horsley's contribution to John Hughlings Jackson's understanding of the mechanisms involved in the generalization of convulsive epileptic seizures. I reviewed Horsley's writings and other relevant late 19th century medical literature. Horsley's combination of strategically sited surgical lesions and cerebral cortex stimulation studies in experimental animals showed that, contrary to Hughlings Jackson's earlier belief, epileptic activity arising in one cerebral hemisphere had to spread to the contralateral hemisphere before bilateral convulsing could occur. On the basis of well-designed experiments, Horsley made a major contribution to the understanding of epileptic seizure propagation mechanisms.